A young emaciated girl sits down in front of her lunch—a lukewarm glass of water and a small package of Melba toast. She’s decided to splurge today; she’s been good. She’s only had a diet Coke, a coffee—black, of course—a few crackers and lots of water in the last four days.

After she’s done the Melba toast, she heads to the bathroom. Guilt-ridden, she looks into the mirror in disgust as a tear trails down her sunken cheek. As she lifts her shirt from her 5’9” frame, the mirror sees ribs with nearly translucent skin wrapped tightly over them. She sees a beer gut and heads to the toilet, two fingers down her throat. The vomit burns her throat and leaves a bad taste in her mouth—but she’s happy with what she’s just accomplished. She’s spoiled herself with six pieces of Melba toast, but now her stomach is clean and that toast won’t end up on her fat ass.

This is the typical image people have of those afflicted with eating disorders—women starving and vomiting to lose weight. Now imagine that this story is about a man.

The usual response is disbelief, since many never imagine men starving themselves or even worrying about their weight, but some men do. In fact, one out of every 10 people afflicted with eating disorders is a man and no one talks or even thinks about it.

That also happens to be one of the only statistics on men and eating disorders available. The National Eating Disorder Information Centre (NEDIC) has tons of stats on women with eating disorders, but none on their male counterparts. Their press material for Eating Disorder Awareness Week (Feb. 2 to 9) never even mentions men. NEDIC director Merryl Bear says less than one percent of the calls that come through the centre are from men.

Ian Boulton, a research fellow with U of T’s Department of Medical Genetics and Microbiology, has become a leading expert on eating disorders in men. Boulton suffered from anorexia nervosa during his early twenties.

His story is only slightly different than the one above, and is typical of men who suffer from eating disorders.

“In the initial phase of my illness I felt energetic and confident, quietly buzzing through the imagined mastery of my life. As I lost more weight, and as my neurochemical makeup became more disturbed, this comparatively bright period was eclipsed by more troubled times,” says Boulton.

“In a few months, my build changed from robust and athletic to emaciated and extremely fragile. Simple daily activities became too challenging to contemplate and remaining upright required considerable exertion.

“I became sexually dysfunctional, socially withdrawn, and the gradual realization of how desperate my situation was made me alternately anxious and deeply depressed.”

Boulton’s obsession became the thing he feared most in life—food. He came to know the enemy well, developing an encyclopedic knowledge of calorific values and nutrition.

“My interest in food became increasingly focused. I could think of nothing else and my mind was haunted with culinary images. Strangely, I derived considerable (if masochistic) pleasure from these mind-mirages and from my continued denial of nutrition. I considered myself powerful because I had beaten hunger.”

After realizing his only options were recovery or death. Boulton went to a number of physicians to seek treatment but was told, “Men don’t get eating disorders.” This common misconception left him feeling abandoned and more hopeless than ever.

Fortunately, Boulton made contact with an “extremely gifted therapist,” with whom he developed a relationship that greatly helped his recovery.

The most common eating disorders are anorexia and bulimia. Anorexia is typified by self-starvation, whereas bulimia is characterized by what is typically called bingeing and purging—gorging on food and then expelling it through self-induced vomiting.

Starvation results in atrophy of muscle tissue and profound fatigue, while severe calorie restriction has neurochemical effects which often precipitate depression and anxiety.

Eating disorders are not about vanity; they’re about issues of self-efficacy, self-esteem and control. Eating disorders are often a manifestation of the need to feel a sense of achievement. Those who suffer from the disorder often are attempting to take control over what they see as the only areas of their life they can regulate.

The basic aspects of eating disorders are similar among men and women, but the main difference is that one in 10 women will develop a clinically definable eating disorder, while only one in a hundred men will experience the same problem. Men also more often describe a need for self-control as a “cause” of their illness, while women tend to be more focused on weight loss as a target.

These differences may be a function of social pressure and prescribed gender roles rather than an inherent, physiologically determined gender bias.

“Both men and women are increasingly seeing their bodies as objects that are to be shaped and turned into commodities,” says Dr. Brian Pronger, a professor of physical education and health at the U of T.

“So people diet and exercise in order to turn their body into a marketable object for potential partners. And it also purchases self-esteem in a culture that expects a certain kind of body.

“Eating disorders are not just about extremes. There is a whole continuum of the ways in which preoccupation with the look of the body is almost ubiquitous in middle-class culture. So what seems to be a normal attitude to the body now is actually a problematic attitude toward the body in shaping it and treating it as an object, which is physically, emotionally and spiritually unhealthy,” explains Pronger.

He believes the increased emphasis on the male figure started with the mainstreaming of queer culture.

“With the beginning of gay liberation in the early 1970s, there came a change in that culture where there was an interest in producing ever more masculine bodies. So I would argue that the emphasis on male body image, which is now widespread, really began in gay culture with that shifting perception of gay men. And of course it was widely popularized and became a part of fashion and so on, and now has spread more widely in the general culture.”

Boulton believes the prescribed gender stereotypes of our culture need to be altered in order for people to realize that not only women suffer from eating disorders.

“I think that we have to adopt a radical if not revolutionary perspective—specifically, that men are actually people. Despite the legacy of patriarchy, masculine posturing and gender preconceptions, men are sentient beings, and critically, exist within the same cultural matrix as women. Consequently, men are exposed to many of the sociological pressures experienced by women, and in light of the increasing focus on ‘male body perfection,’ it is unsurprising that men develop eating disorders.”

While eating disorders affect a small percentage of the population, the disease underlying eating disorders is much more pervasive. It’s spread by the media and its perpetuation of an idealized standard of what a human being should look like.

“Many aspects of our culture (i.e. post-modern consumer capitalism) are pathological,” explains Boulton. “I think that eating disorders are best prevented through self-acceptance and a rejection of our impersonal ‘mass-marketing’ cultural model.”

Boulton points out that people need to realize that the mass media is, in large part, a selling machine. It capitalizes on our insecurities, compelling us to spend on things we believe will help us achieve the aesthetic ideal. In most cases we are buying an empty dream.

“Happy, healthy, self-actualized and content individuals don’t make good consumers. They tend to be proactive rather than apathetic, and they tend to cultivate awareness rather than accepting blatant propaganda.

“Consequently, our cultural overlords have a lot to lose. It takes a great deal of courage and tenacity to challenge the dominant view, especially when, on the surface at least, it appears so comfortable.”

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